RT Journal Article
SR Electronic
T1 The long-term outcomes and histological transformation in class II lupus nephritis
JF Saudi Medical Journal
JO Saudi Med J
FD Prince Sultan Military Medical City
SP 990
OP 993
DO 10.15537/smj.2018.10.22435
VO 39
IS 10
A1 Abdulkareem O. Alsuwaida
A1 Amaar A. Bakhit
A1 Feras A. Alsuwaida
A1 Junaid J. Wadera
A1 Hala M. Kfoury
A1 Sufia Husain
YR 2018
UL http://smj.org.sa/content/39/10/990.abstract
AB Objectives: To examined the short and long-term outcome of class II lupus nephritis (LN).Methods: This retrospective study included patients with class II LN at their first renal biopsy between January 1996 and December 2016 in King Khaled University Hospital, Riyadh, Saudi Arabia. The rate of complete remission, worsening renal function, and histological transformation in the second biopsy were examined.Results: The study included 32 female patients with class II LN. The most frequent presentation (62.5% of patients) was hematuria with subnephrotic range proteinuria. The clinical presentation included acute kidney injury in 22% of patients, and 9.4% had nephrotic range proteinuria. Management with steroid monotherapy in 25 patients resulted in complete remission for 92% of these patients at 6 months. After a median follow up of 8 years, 2 patients had a doubling of their serum creatinine. During the follow up 17 patients (53%) needed a second biopsy, which revealed transformation to other classes (65%).Conclusions: Daily steroid monotherapy may be an appropriate first-line treatment for class II LN that presents with subnephrotic range proteinuria and normal kidney function. Patients with acute kidney injury and/or nephrotic range proteinuria may warrant more aggressive immunosuppressive regimens.